At A Glance
Behavioural and psychological symptoms of dementia (BPSD), including agitation, aggression, and responsive behaviours, are common in acute and long-term care settings and can significantly impact patient wellbeing and care delivery.
A growing body of evidence—including randomized controlled trials, feasibility studies, and observational research—suggests that virtual reality (VR) may provide a safe, non-pharmacological intervention that supports behavioural regulation, reduces symptom severity during episodes of distress, and promotes calm engagement in older adults living with dementia (Appel et al., 2022; Appel et al., 2024).
Key Research Findings
VR reduces aggressive behaviours in a randomized controlled trial
A randomized controlled trial in acute care dementia patients found statistically significant reductions in aggressive behaviours, including physical aggression and vocal agitation, following VR therapy compared with standard care (Appel et al., 2024, randomized controlled trial).
VR is associated with reductions in behavioural and psychological symptom severity
Across clinical and pilot studies, VR has been associated with reductions in broader behavioural and psychological symptom (BPSD) severity, including agitation and distress during and following intervention periods (Appel et al., 2024, randomized controlled trial; Appel et al., 2021, acute care pilot study).
Calm engagement is frequently observed during VR sessions
In long-term care settings, responsive behaviours were not observed during or immediately following 61% of VR sessions in veterans living with dementia, suggesting periods of calm engagement even in individuals with significant cognitive impairment (Appel et al., 2022, long-term care veteran study).
VR may reduce the need for as-needed pharmacological intervention during behavioural episodes
No as-needed medications were administered during VR-supported behavioural management sessions in long-term care contexts, indicating potential as a non-pharmacological adjunct during periods of distress (Appel et al., 2022, long-term care veteran study).
VR may support improved quality of life alongside behavioural outcomes
In addition to behavioural symptom changes, randomized and pilot studies report improvements in quality of life outcomes, suggesting broader benefits beyond symptom management alone (Appel et al., 2024, randomized controlled trial).
VR is safe and well tolerated in dementia care settings
Across acute and long-term care studies, VR has been well tolerated in older adults with cognitive impairment, with no serious adverse events reported (Appel et al., 2020, feasibility study; Appel et al., 2024, randomized controlled trial).
Standardized observation tools support structured behavioural measurement
The development of tools such as ObsRVR has enabled more systematic and reliable assessment of behavioural and emotional responses during VR exposure in dementia care contexts (Appel et al., 2021, acute care observational instrument study).
Why This Matters
Managing agitation, aggression, and responsive behaviours is one of the most complex challenges in dementia care, particularly in acute hospital and long-term care environments. These symptoms can impact safety, care delivery, and quality of life for both residents and staff.
While pharmacological approaches are sometimes necessary, there is increasing emphasis on non-pharmacological interventions that reduce distress without adding medication burden or side effects. VR offers a structured, non-invasive option that can be delivered during periods of escalation or as part of routine care.
Current evidence suggests that VR may help support calm engagement and reduce behavioural symptom severity during care episodes, providing care teams with an additional tool for person-centred behavioural support.
Our Publications
Randomized Controlled Trial (2024)
Long-Term Care Veteran Study (2022)
Observational Instrument Study (2021)
Feasibility Study (2020)